Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/74—Synthetic polymeric materials
  • A61K31/785—Polymers containing nitrogen
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
  • A61K9/0056—Mouth soluble or dispersible forms; Suckable, eatable, chewable coherent forms; Forms rapidly disintegrating in the mouth; Lozenges; Lollipops; Bite capsules; Baked products; Baits or other oral forms for animals
  • A61K9/0058—Chewing gums
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
  • A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
  • A61K9/5005—Wall or coating material
  • A61K9/5021—Organic macromolecular compounds
  • A61K9/5026—Organic macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyvinyl pyrrolidone, poly(meth)acrylates
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/06—Antihyperlipidemics

Definitions

• Cholestyramine is a well-known ion-exchange resin which has pharmaceutical utility as an antihyper- lipemic agent which lowers serum cholesterol.
• Cholestyramine resin combines with the bile acids to form an insoluble complex that is secreted in the feces, thereby leading, eventually, to a decrease in serum cholesterol levels.
• cholestyramine While cholestyramine is highly effective, it is gritty or sandy in texture, making it unpleasant in appearance and mouthfeel.
• One result of this unpleasantness is reduced patient compliance in that individuals who ingest the resin on a regular basis may avoid taking all of the resin they need.
• Combination products ie., compositions which contain cholestyramine and one or more other beneficial substances or drugs are difficult to formulate because of the ionic character of the resin.
• an acidic drug cannot be readily administered along with cholestyramine because the drug can bind to the ionic sites on the resin, and thereby reduce the effectiveness of both agents.
• compositions containing cholestyramine or other lipid modifier(s) of ionic character can be produced by pretreating the ionic lipid modifier using a certain regimen.
• the treated lipid modifier(s) can be combined with at least one other beneficial substance, e.g. a second lipid lowering agent.
• cholestyramine resin is granulated to yield granules whose particle size ranges from about 10 to about 100 microns. These granules are then coated with a material which is acid resistant, but soluble in the intestinal juice of the duodenum or other portion of the intestines where bile acids are secreted. This pretreated cholestyramine can then be administered alone or in combination with other drugs or beneficial substances.
• compositions of the invention have several advantages over known compositions containing cholestyramine resin.
• the pretreated cholestyramine resin is in a form which makes it readily includable into various dosage forms such as candy bars, chewing gum, liquid and semi-solid suspensions, sprinkle systems, tablets capsules and the like.
• the coating process used in the pretreatment virtually assures that the cholestyramine or other ionic component will not react to any significant extent before it reaches the proper location in the gastrointestinal tract so that its efficacy is maximized.
• the invention involves a composition and a method by which the interaction between cholestyramine and other drugs, especially other lipid regulating drugs, if any, is minimized when the cholestyramine is ingested alone or in combination by human subjects.
• compositions of the invention contain:
• the invention is also concerned with methods of use of pretreated lipid regulator(s) alone or in combination with other drug(s) for the preparation of pharmaceutical compositions for hyperlipidemic therapy.
• the composition or series of compositions are formulated such that the active or reactive agents in each drug is absorbed with maximum efficiency in the body.
• the coating material used in step (2) be soluble in the juices of the proximal a duodenal region of the intestine, i.e., in that portion of the intestine in which bile acids are present in significant amounts.
• significant amounts mean quantities in which bile acids can be effectively bound to the reactive sites of an ionic lipid modifier such as cholestyramine so that their concentration in the bloodstream is lowered.
• the drug combinations of the invention will combine a lipid regulator, eg., cholestyramine and at least one other beneficial or therapeutic material.
• the lipid regulator(s) useful in the invention can be selected from any of those conventionally employed whose ionic character render them suitable for binding bile salts and/or other fatty materials.
• Useful lipid regulators include those which act by ionic mechanisms to remove one or more fatty substances from the bloodstream and to increase the concentration of same in fecal excretions.
• Preferred lipid modifiers of the ionic type are cholestyramine, colestipol, and the like and their pharmaceutically acceptable salts, e.g, cholestipol HCI.
• Combinations of cholestyramine and other anionic exchange resins, are contemplated.
• Combinations containing lipid modifiers which do not act by ionic mechanisms are also comtemplated, e.g, gemfibrozil and cholestyramine can be combined.
• Cholestyramine is a pharmacologically important anionic-exchange resin.
• the basic quaternary ammonium-exchange functionalities in the resin are attached to a styrene-divinylbenzene copolymer skeleton.
• cholestyramine is capable of increasing the fecal excretion of endogenous bile salts, thereby significantly decreasing the extent of absorption of fats and fatty materials.
• This resin also possesses the ability to lower plasma cholesterol levels by binding bile-salt anions in the small intestine.
• One article which discusses the resins binding capacity is W. J. Johns and T. R. Bates, "Quantification of the Binding Tendencies of Cholestyramine I; Effect of Structure and Added Electrolytes on the Binding of Unconjugated and Conjugated Bile-Salt Anions,"Journal of Pharm. Science , vol. 58, No. 2, February, 1969, pp. 179-83. The content of that article is hereby incorporated by reference.
• cholestyramine and/or other lipid modifiers of ionic character are used in combination with one or more agents which inhibit the production and/or absorption of cholesterol.
• Suitable agents include, but are not limited to, fabric acid derivatives, cholereductase inhibitors, antihyperlipoproteinemics and the like.
• Useful lipid lowering/regulating agents include-but are not limited to-gemfibrozil, dextrothyroxine, the fibrates, e.g, fenofibrate, clofibrate, bezafibrate, ciprofibrate, mevinolin, synvinolin, niacin, hormonal preparations, e.g, T3-and/or T4-containing agents, fish oils and/or extracts of such oils, eptastin, the neomycins, probucol, nicotinic acid, and the like, as well as their pharmaceutically acceptable salts and esters, e.g, dextrothyroxine sodium, gemfibrozil HCI and the like. Gemfibrozil and its pharmaceutically acceptable derivatives are preferred.
• Mixtures of lipid moderators which are not of ionic character are operable, as are mixtures which contain a plurality of ionic-type moderators and a plurality of one or more other types.
• lipid reducing agent(s) will be present in the final therapeutic compositions will vary depending upon the nature of the agents(s) selected and the desired therapeutic effect to be achieved.
• the concentration of cholestyramine will be from about 5 to about 80, preferably about 30 to about 60 weight percent, based on total composition weight.
• a second lipid modifier ie., one which is not of ionic character -it will generally be present in a concentration of about 5 to about 80, preferably about 30 to about 60, weight percent by weight.
• compositions of the invention can also contain a wide variety of other drugs or beneficial substances.
• Suitable categories of drugs that may be employed in combination with the instant treated lipid moderator(s) may vary widely and generally represent any stable drug combination. Illustrative categories and specific examples include:
• the weight percent of the non-lipid modifying drug or salt thereof, based on the weight of the total composition, will be form about 2% to about 80% and preferably about 5% to about 50% by weight, which amounts can vary depending upon the therapeutic dosage permitted.
• the drugs, minerals, and vitamins discussed above can be employed in any of their pharmaceutically acceptable forms.
• salts eg., hydrochlorides, borates, pamoates, and the like as well as other analogs, metabolites and/or pro drugs related to the same may be used. Mixtures are operable.
• One preferred group of materials to be combined with the treated lipid modifiers of the invention in orally administrable compositions includes phenylbutazone, warfarin, and chlorthiazide, as well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, digitalis chlorpropamide 25S, niacin -6"C, ascorbic acid, aspirin, salicylic acid, phenoborbitol 14C, sulfadiazine, linocomycin HCI, tetacycline HCI and the like and their pharmaceutically acceptable analogs, e.g. salts. Combinations of these drugs can be employed.
• the process by which the primary ionic lipid reducer is treated in order to maximize its compatability with other drugs in the system is a novel one.
• the granulation step involves agglomeration or other suitable processing to yield granules or other generally spherical particles whose size range from about 30 to about 100, microns. Suitable devices for the granulation step are well known in the art. If the lipid modifier is supplied in a form which is suitable for coating, the granulation step may be omitted, i.e, granulation is optional.
• the particles are then coated with a pharmaceutically acceptable material which is acid resistant, so that the granules remain coated as they pass through the stomach after ingestion.
• a pharmaceutically acceptable material which is acid resistant, so that the granules remain coated as they pass through the stomach after ingestion.
• enteric coating materials are generally termed enteric coating materials and are well known in the art. Mixtures of such materials can be used.
• the acid resistant coating also be soluble in that region of the intestines in which bile salts and other fatty substances can be absorbed, or bound, by the resin, so that they are then taken out of the bloodstream and excreted along with fecal matter.
• Suitable coating materials are commercially available materials, or combinations of some, which have requisite solubility.
• the coating material should be insoluble at the pH generally found in the stomach, but soluble at the pH general found at the proximal intestine. In general, the coating material should be insoluble at pH's less than 5, preferably pH's less than 4, but soluble at the pH of the proximal intestine, ie, about 4 to about 7, preferably about 4 to about 5.
• Preferred coating materials are polymers or polymer precursors (e.g monomers and/or resin intermediates) whose films have the solubility properties discussed above. Mixtures are operable.
• the method by which the coating material(s) is applied to the primary lipid regulator is not crucial. It is sufficient for the purposes of this invention that this lipid regulator be coated, encapsulated or otherwise treated with the coating material so that little or no association of the ionic lipid regulator takes place in an acid environment, i.e., in the stomach.
• one or more of the other drugs employed in the combinations of the invention can be suitably pretreated.
• One preferred treatment involves the taste-masking system set out in U.S.SN. 811,601 (W-L PD #3456-7-DAS).
• compositions are to be administered orally, it is contemplated that any system which affords ingestion via the gastro-intestinal tract can be used.
• formulations for ingestible tablets, pellets, sprinkles, suspensions, gels, candy bars, chewy candy, chewing gums, lozenges, and the like are contemplated. combinations of these, e.g., lozenges with chewing candy centers, are useful.
• Two preferred dosage forms are edible candy formulations and chewing gum formulations.
• Such formulations can contain fillers, waxes, sweeteners, stabilizers, flavoring agents, fragrance enhancers, processing aids, and the like, which are conventionally used in the confectionery arts.
• suitable sweeteners include aspartame, saccharine, glucose, sucrose, fructose, xylitol, and the like and combinations thereof.
• Excipients such as fillers, stabilizers and other additives conventionally employed in the pharmaceutical industry and in the candy and confectionery industry, can be used in suitable amounts in the compositions of the invention.
• the dosage forms produced in accordance with the invention will be employed to deliver drugs to human recipients in suitable quantites for the therapeutic effect(s) desired, i.e., at dosage levels which are consistent with the therapeutic needs of the patient and the desires of his or her physician.
• daily dosage levels are well-known for the lipid regulators employed in the invention and need not be spelled out here.
• reference sources such as the Physic i a n s ' Desk Reference, and drug manufacturer's specifications and instructions can be consulted to determine proper drug concentration levels and/or dosage regimens for the combinations of the invention.
• This example shows the effect of pH on the binding of gemfibrozil to untreated cholestyramine.
• Gemfibrozil solutions were prepared in 0.05 M acetate buffer, pH 4.5, and 0.05 M phosphate buffer, pH 6.0 and 7.5 as follows:
• the concentration of gemfibrozil in each buffer, determined from absorbance at 280 nm was: pH 4.5, 0.014 mg/ml; pH 6.0, 0.150 mg/ml; pH 7.5, 1.711 mg/ml. Cholestyramine (10 mg) was added to 20 ml of each gemfibrozil solution and the mixtures were agitated for 2 hours. The mixtures were filtered and the concentration of unboud gemfibrozil was determined.
• This example shows the effect of pH on the binding of gemfibrozil which has been treated in accordance with the invention.
• the experimental procedure was the same as in Example I.
• the coated material contained fifty percent active resin.

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Cited By (9)

Citations (3)

• 1987
  • 1987-09-04 ZA ZA876640A patent/ZA876640B/xx unknown
  • 1987-09-23 FI FI874164A patent/FI874164A/fi not_active Application Discontinuation
  • 1987-09-23 PT PT85775A patent/PT85775B/pt not_active IP Right Cessation
  • 1987-09-24 AU AU78948/87A patent/AU7894887A/en not_active Abandoned
  • 1987-09-25 EP EP87114072A patent/EP0261693A1/de not_active Withdrawn
  • 1987-09-25 IE IE872589A patent/IE872589L/xx unknown
  • 1987-09-25 DK DK504187A patent/DK504187A/da not_active Application Discontinuation
  • 1987-09-25 NO NO874040A patent/NO874040L/no unknown
  • 1987-09-25 JP JP62239093A patent/JPS63152321A/ja active Pending
  • 1987-09-26 KR KR870010697A patent/KR880003628A/ko not_active IP Right Cessation

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